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Background and Aim: One of the most important bacterial resistance mechanisms is production of Extended-Spectrum Beta-Lactamase (ESBL). In addition, ESBL strains usually have resistance to several antibiotic classes, because multiple resistance genes are often carried by a plasmid. One of these multiple resistances is the simultaneous resistance to quinolones and ESBL production. The aim of this study was to determine the prevalence of resistance to fluoroquinolones in ESBL-producing Klebsiella pneumoniae isolates in Sanandaj health centers in 2018. Materials and Methods: Evaluation of antibiotic susceptibility in all isolates (phenotypically and at Minimum inhibitory concentration (MIC) and identification of ESBL strains were performed by VITEK2. We evaluated the relationship between ESBL production and resistance to fluoroquinolones (ciprofloxacin and levofloxacin) by statistical tests. Results: According to the antibiotic susceptibility results of 67 isolates, 35 isolates (52.23%) were resistant to ciprofloxacin and levofloxacin. 25 isolates (37.31%) were identified as ESBL, of which 19 isolates (76%) were resistant to levofloxacin and ciprofloxacin and only 6 isolates (24%) were sensitive to these antibiotics. Statistical analysis showed that resistance to ciprofloxacin and levofloxacin was significantly increased in ESBL isolates compared to that in non-ESBL isolates (P-value = 0.003). Conclusions: In this study, simultaneous resistance to fluoroquinolones (ciprofloxacin and levofloxacin) and ESBL production was observed in Klebsiella pneumoniae isolates, which can limit treatment options. Also, the results of this study showed that the treatment of the ESBL Klebsiella pneumoniae infection with levofloxacin and ciprofloxacin antibiotics will be a challenge in these medical centers.

Background and purpose: Due to emerging antibiotic-resistant bacteria, finding effective alternative antimicrobials to combat the bacteria is unavoidable. Bacteriophage therapy as a biologic and highly potentiated therapeutic approach was considered recently. This study aimed to isolate lytic bacteriophage(s) against multi-drug resistant clinical isolates of Klebsiella pneumonia and evaluate the morphological and biological characteristics as candidates for phage therapy. Materials and methods: Obtained clinical isolates from Shahid Madani Hospital in Tabriz, were confirmed as K. pneumoniae, and an antibiotic sensitivity test was performed using the standard disk diffusion method. Then, the isolation of lytic bacteriophages against 16 selected antibiotic-resistant bacterial isolates was carried out. Briefly, samples for phage isolating were gained from sewage water and centrifuged. The supernatant was filtered using a 0.45 µm Filter, mixed with fresh tripton soy broth medium and magnesium sulfate and incubated at room temperature. Then, the solution was mixed with chloroform and evaluation of plaque formation was performed using the agar bilayer technique. Genomes of the bacteriophages were subjected to molecular analysis using Hind III and EcoRV enzymes. Host range determination of the isolated bacteriophages was evaluated using spot test and agar bilayer techniques. Three bacteriophages with a broader host range than others were selected for more characterization. One step growth curve of the phages was drawn and their latent period and burst size were investigated. Then, the stability and survivability of the isolated lytic bacteriophages to different temperatures (-20, 37, 50℃), different rates of pH value (3,4,5,7,9,11,12), and also UV radiation were evaluated. Finally, morphological characteristics of bacteriophage with the broadest host range (PKpMa2/20) were investigated using electron microscopy. Results: 36 clinical bacterial isolates were confirmed as K. pneumoniae based on standard biochemical tests. In the antibiotic susceptibility assay, it was revealed that the highest and lowest rates of antibiotic resistance belonged to cefazoline (80%) and tobramycin (26%) respectively. Isolation of bacteriophages against all 16 selected isolates was successfully performed. After the extraction of the genomes of the phages, a high variety of genome sequences was detected according to molecular analysis. In host range determination, PKpMa2/20 had lytic activity against 11 of 15 isolates. In a study of the one-step growth curve of the phages, with a broader host range than other isolated bacteriophages, latent periods were shown 10, 10, and 15 min and their burst size were 350, 210, and 180 pfu/ml respectively. All of the phages showed appropriate stability in temperatures of -20 and 37 ℃. In the temperature of 50℃, the survivability of PKpMa2/20 was higher than two other phages. Also, PKpMa2/20 was stable in the pH range of 3-12; in the pH value of 3, two other phages stability was ceased but PKpMa2/20 showed appropriate lytic activity. In electron microscopy, PKpMa2/20 had a short tail length of 10 nm and a head with a diameter of about 60 nm that possibly belonged to the family Podoviridae. Conclusion: Based on appropriate lytic effects, latent period, and burst size of the three isolated bacteriophages in the current study, especially PKpMa2/20, and also, their high stability to different temperatures, pH, and UV radiation, they could be considered as candidates for phage therapy to control resistant strains of K. pneumoniae infections but for the therapeutic use of theses phages, more molecular analysis is needed.

Background and purpose: Due to emerging antibiotic-resistant bacteria, finding effective alternative antimicrobials to combat the bacteria is unavoidable. Bacteriophage therapy as a biologic and highly potentiated therapeutic approach was considered recently. This study aimed to isolate lytic bacteriophage(s) against multi-drug resistant clinical isolates of Klebsiella pneumonia and evaluate the morphological and biological characteristics as candidates for phage therapy. Materials and methods: Obtained clinical isolates from Shahid Madani Hospital in Tabriz, were confirmed as K. pneumoniae, and an antibiotic sensitivity test was performed using the standard disk diffusion method. Then, the isolation of lytic bacteriophages against 16 selected antibiotic-resistant bacterial isolates was carried out. Briefly, samples for phage isolating were gained from sewage water and centrifuged. The supernatant was filtered using a 0.45 µm Filter, mixed with fresh tripton soy broth medium and magnesium sulfate and incubated at room temperature. Then, the solution was mixed with chloroform and evaluation of plaque formation was performed using the agar bilayer technique. Genomes of the bacteriophages were subjected to molecular analysis using Hind III and EcoRV enzymes. Host range determination of the isolated bacteriophages was evaluated using spot test and agar bilayer techniques. Three bacteriophages with a broader host range than others were selected for more characterization. One step growth curve of the phages was drawn and their latent period and burst size were investigated. Then, the stability and survivability of the isolated lytic bacteriophages to different temperatures (-20, 37, 50℃), different rates of pH value (3,4,5,7,9,11,12), and also UV radiation were evaluated. Finally, morphological characteristics of bacteriophage with the broadest host range (PKpMa2/20) were investigated using electron microscopy. Results: 36 clinical bacterial isolates were confirmed as K. pneumoniae based on standard biochemical tests. In the antibiotic susceptibility assay, it was revealed that the highest and lowest rates of antibiotic resistance belonged to cefazoline (80%) and tobramycin (26%) respectively. Isolation of bacteriophages against all 16 selected isolates was successfully performed. After the extraction of the genomes of the phages, a high variety of genome sequences was detected according to molecular analysis. In host range determination, PKpMa2/20 had lytic activity against 11 of 15 isolates .In a study of the one-step growth curve of the phages, with a broader host range than other isolated bacteriophages, latent periods were shown 10, 10, and 15 min and their burst size were 350, 210, and 180 pfu/ml respectively. All of the phages showed appropriate stability in temperatures of -20 and 37 ℃. In the temperature of 50℃, the survivability of PKpMa2/20 was higher than two other phages. Also, PKpMa2/20 was stable in the pH range of 3-12; in the pH value of 3, two other phages stability was ceased but PKpMa2/20 showed appropriate lytic activity. In electron microscopy, PKpMa2/20 had a short tail length of 10 nm and a head with a diameter of about 60 nm that possibly belonged to the family Podoviridae. Conclusion: Based on appropriate lytic effects, latent period, and burst size of the three isolated bacteriophages in the current study, especially PKpMa2/20, and also, their high stability to different temperatures, pH, and UV radiation, they could be considered as candidates for phage therapy to control resistant strains of K. pneumoniae infections but for the therapeutic use of theses phages, more molecular analysis is needed. [ABSTRACT FROM AUTHOR]

Introduction: Urinary tract infection (UTI) is one of the most important and common infections in children. The aim of this study was to investigate the frequency of qnrB and qnrS genes in Escherichia coli and Klebsiella pneumoniae isolated from urinary tract infections of children in 17 Shahrivar Hospital in Rasht. Methods: In this descriptive cross-sectional study, 49 strains of Escherichia coli and Klebsiella pneumoniae were isolated from 17 Shahrivar Hospital in Rasht and identified using biochemical methods. Sensitivity and resistance of strains to antibiotics were determined by Kirby Bohr and dilution broth methods. PCR method was used to evaluate the frequency of qnrS and qnrB genes in isolates. Results: In this study, the highest resistance was observed in piperacillin (81.5%) and cefazolin (88.9%) isolates from Escherichia coli and in Klebsiella pneumoniae (cefazolin (90.9%) and amoxicillin (95.5%) isolates from 49 Isolated, 73.4% had qnrB gene and 97.9% had qnrS gene. Conclusions: It seems that one of the reasons for increasing multidrug resistance in hospital isolates of urinary tract infection (UTI) in Rasht is the increased transfer of plasmid genes between these isolates. [ABSTRACT FROM AUTHOR]

Introduction: Escherichia coli (E. coli) is one of the major pathogens causing urinary tract infection (UTI). The Spread of Extended-Spectrum β-Lactamases (ESBL)/AmpC enzymes has become a major issue, particularly due to the antibiotic therapeutic failures that result in less favorable patient outcomes, including higher mortality. This study aimed to investigate the prevalence of phenotypic and genotypic beta-lactamase resistance in E. coli strains isolated from the urine sample. Methods: A total of 231 E. coli isolates were collected from urine samples of patients from Tehran Children's medical center hospital between 2012 to 2015. The antibiotic resistance pattern of clinical isolates was determined by using the disk diffusion method. AmpC β-lactamases and ESBLs, alone and in combination, could reliably be detected using a disc diffusion method. Genes encoding beta-lactamases were detected by PCR method using β-lactamase gene-specific primers. Results: All isolates of the present study were resistant to ampicillin and cefazoline. The resistance rate to other antibiotics was as follows: trimethoprim-sulfamethoxazole 85.7%, gentamicin 37.6%, levofloxacin 35.9%, and cefoxitin 24.6%. A high sensitivity rate was observed against meropenem and nitrofurantoin. Among collected isolates, 81.5% were ESBLsproducers. The prevalence of ESBLs production in CTX-M, SHV, and TEM was 100%, 35%, and 46.7%, respectively. Among 68 presumptive AmpC producers, CIT was the most prevalent detected gene, while FOX was the least seen. Conclusion: Regarding the production of ESBL by some E. coli isolates, phenotypic detection for determining the antibiotic profile and resistance genes is recommended to formulate an effective antibiotic therapy. [ABSTRACT FROM AUTHOR]

Introduction: In this study, the antimicrobial activity of biologically synthesized zinc (Zn) and copper (Cu) nanoparticles was investigated on gram-positive and gram-negative bacteria, pathogens, and resistant and common nosocomial infections. Material & Methods: Intially, zinc oxide and copper nanoparticles were synthesized using Xanthomonas campestris and Pseudomonas stutzeri bacteria, respectively. To investigate the effect of different concentrations of nanoparticles on bacteria using the macrodilution method, concentrations of 0.01, 0.1, 0.5, 1, and 1.5% of Zn and Cu nanoparticles (culture medium + nanoparticles) were prepared and were added to the respective bacteria at a concentration of 105 cell/ml. Containers containing treated media (bacteria + nanoparticles) and control media were placed in a shaker incubator. Afterward, the optical density (OD) of treatment and positive control and negative control media were determined. (Ethic code: IR.ILAM.REC.1401.008) Findings: The results of statistical analysis showed that Zn and Cu nanoparticles, at a concentration of 0.5%, were able to remove almost all (100%) Klebsiella pneumoniae, Acinetobacter baumannii, Staphylococcus aureus bacteria and were bacteriostatic at the concentration of 0.1%. Discussion & Conclusion: The results obtained from the determination of antibacterial properties of nanoparticles showed a direct relationship between the concentration of nanoparticles and the percentage of bacterial removal.

Background & aim: The use of broad-spectrum cephalosporins in the treatment of infections has led to the emergence of a new class of beta-lactamases called metallobetalactamase, these enzymes belong to Ambler's class B beta-lactamases. Group A and B metallobetalactamases in Enterobacteriaceae cause problems in treatment. The present study was conducted with the aim of phenotypic investigation of Escherichia coli and Klebsiella pneumoniae metallobetalactamase producing strains, as well as molecular investigation of SPM, VIM, SIM, IMP and GIM genes. Methods: The present descriptive-quantitative study was conducted on 185 patients hospitalized in the special care units of Milad Hospital in Tehran from March to May 2018-2019, and 45 strains of Escherichia coli and 62 strains of Klebsiella pneumoniae were selected. In order to check the antibiotic resistance of the strains, diffusion test in agar was used and also to check the phenotypic of the metallobetalactamase producing strains, the combined disc method was used. Molecular investigation of metallobetalactamase producing genes was done by PCR method. The collected data were analyzed using Fisher's test. Results: In the present study, the highest antibiotic resistance of Escherichia coli and Klebsiella pneumoniae strains was observed to cotrimoxazole and cefepime antibiotics, respectively. 14.5% of Klebsiella pneumoniae strains and 15.5% of Escherichia coli strains produced metallobetalactamase enzyme in the phenotypic method. Also, 88.9% of the studied Escherichia coli strains carried the SPM gene, 40% carried the VIM gene, 66.7% carried the SIM gene, and 15.6% carried the IMP gene. SPM, VIM, SIM, IMP and GIM genes were found to be 54.8, 41.9, 58.1, 3.2 and 8.1% in Klebsiella pneumoniae strains, respectively. Conclusion: In the present study, there was a high percentage of genes producing metallobetalactamase enzyme in bacteria, while 14.5% of Klebsiella pneumoniae strains and 15.5% of Escherichia coli strains were producing metallobetalactamase enzyme in the phenotypic method. that genes producing enzymes exist in bacteria and are not expressed in high amounts. There waS also the possibility that these genes were expressed, but could not be checked with the usual phenotypic methods, so efforts should be made to find reliable, cheap and easy phenotypic methods for phenotypic examination.

Background & aim: In recent years, the rate of antibiotic resistance has been increasing which has led to the limitation of ways to control hospital infections (especially surgical site infections) and accurate treatment options. Therefore, the aim of the present study was to determine and investigate the frequency of plasmid-dependent quinolone resistance genes in Klebsiella pneumoniae, Pseudomonas aeruginosa, and Escherichia coli isolated from surgical site infections. Methods: The present cross-sectional descriptive study was conducted on 45 isolates of Klebsiella pneumoniae, Pseudomonas aeruginosa, and Escherichia coli isolated from surgical site infections of patients hospitalized at Yasuj hospitals in 2018. After identifying the isolates, they were checked for resistance to quinolone drugs by diffusion method from agar disk. Then, quinolone resistant isolates were examined for the presence of qnrB, qnrA and qnrS genes using PCR method. The collected data were analyzed using descriptive statistical tests and SPSS version 25 software. Results: The highest rate of antibiotic resistance to Ciprofloxacin was 75.7%, and the rate of resistance to Levofloxacin and Ofloxacin were 73.3 and 62.2 percent, respectively; 24 (70.6%) isolates had at least one qnr gene, among these 24 isolates, 7 (20.6%) isolates contained qnrB gene, 4 (11.8%) isolates contained qnrA gene and 13 (2. 38 percent) isolates carried the qnrS gene. The results of the present study indicated the high prevalence of quinolone resistance due to plasmid (70.7%) among all isolates resistant to quinolones. Conclusion: The final results of the present study indicated that the level of resistance to quinolone antibiotics in gram-negative bacteria isolated from surgical site infections had a high and significant prevalence, hence the use of appropriate treatment methods and correct and rational prescription antibiotics by physicians are correspondingly significant in their control.

Background & aim: The use of broad-spectrum cephalosporins in the treatment of infections has led to the emergence of a new class of beta-lactamases called metallobetalactamase, these enzymes belong to Ambler's class B beta-lactamases. Group A and B metallobetalactamases in Enterobacteriaceae cause problems in treatment. The present study was conducted with the aim of phenotypic investigation of Escherichia coli and Klebsiella pneumoniae metallobetalactamase producing strains, as well as molecular investigation of SPM, VIM, SIM, IMP and GIM genes. Methods: The present descriptive-quantitative study was conducted on 185 patients hospitalized in the special care units of Milad Hospital in Tehran from March to May 2018-2019, and 45 strains of Escherichia coli and 62 strains of Klebsiella pneumoniae were selected. In order to check the antibiotic resistance of the strains, diffusion test in agar was used and also to check the phenotypic of the metallobetalactamase producing strains, the combined disc method was used. Molecular investigation of metallobetalactamase producing genes was done by PCR method. The collected data were analyzed using Fisher's test. Results: In the present study, the highest antibiotic resistance of Escherichia coli and Klebsiella pneumoniae strains was observed to cotrimoxazole and cefepime antibiotics, respectively. 14.5% of Klebsiella pneumoniae strains and 15.5% of Escherichia coli strains produced metallobetalactamase enzyme in the phenotypic method. Also, 88.9% of the studied Escherichia coli strains carried the SPM gene, 40% carried the VIM gene, 66.7% carried the SIM gene, and 15.6% carried the IMP gene. SPM, VIM, SIM, IMP and GIM genes were found to be 54.8, 41.9, 58.1, 3.2 and 8.1% in Klebsiella pneumoniae strains, respectively. Conclusion: In the present study, there was a high percentage of genes producing metallobetalactamase enzyme in bacteria, while 14.5% of Klebsiella pneumoniae strains and 15.5% of Escherichia coli strains were producing metallobetalactamase enzyme in the phenotypic method. that genes producing enzymes exist in bacteria and are not expressed in high amounts. There waS also the possibility that these genes were expressed, but could not be checked with the usual phenotypic methods, so efforts should be made to find reliable, cheap and easy phenotypic methods for phenotypic examination.

Background and Aim: Klebsiella pneumoniae is one of the most common causes of community-acquired and nosocomial infections and has acquired numerous resistance mechanisms over time. The aim of this study was to evaluate the antibiotic resistance pattern of clinical isolates of K. pneumoniae and investigate the mutations in Ompk35 porin as one of the most important mechanisms of resistance to beta-lactam antibiotics. Materials and Methods: In this cross-sectional correlation study, 100 urinary isolates of K. pneumoniae from the patients admitted to Milad Hospital were evaluated. Antibiotic susceptibility testing was performed using disk diffusion method. Using PCR method, ompK35 genes were detected, sequenced and the mutations were identified by use of Mega software (version 3.7.3). SPSS software version 20 and Chi-square test were used for data analysis. Results: The highest resistance rate belonged to amikacin (74%) followed by levofloxacin (69%). Resistance rates to cefepime, gentamicin, ciprofloxacin, meropenem, and ceftriaxone were 62, 58, 53, 41, and 35%, respectively. The highest sensitivity rate belonged to imipenem (80%). Numerous mutations were observed in the Ompk35 porin encoding genes. Among the isolates, 70% harbored mutations in Ompk35 protein and two isolates had five mutations simultaneously. There was no significant relationship between resistance to the antibiotics and gender in our study (P>0.05). Conclusion: Our findings indicated a high prevalence rate of antibiotic resistance and high frequency of porin mutations among K. pneumoniae isolates. Also, the presence of similar mutations in the isolates suggests that they may have a common origin.

Background & aim: There are several reports regarding the increase and growing prevalence of ESBLs producing organisms from different regions in the country. Considering that Klebsiella pneumoniae includes a significant percentage of hospital infections, therefore, knowing the pattern of resistance and sensitivity of this bacterium to beta-lactam antibiotics plays a significant role in the treatment and control of infections caused by this bacterium. As a result, the aim of the present study was to determine and evaluate the frequency of beta-lactamases The broad spectrum of Klebsiella pneumoniae urinary isolates was drug-resistant by genotypic and phenotypic methods. Methods: In the present cross-sectional descriptive study conducted in 2018, 100 strains of Klebsiella pneumoniae were isolated from urine samples of patients with urinary tract infection from Al-Zahra Hospital, Isfahan. Klebsiella pneumoniae strains were identified and confirmed using standard biochemical tests. Antibiotic sensitivity pattern was investigated by disk diffusion method based on CLSI criteria. To perform the phenotypic verification test of broad-spectrum β-lactamase producing strains, the combined disc method was used based on CLSI criteria. PCR test was done with specific primers to identify blaSHV and bla TEM. The collected data were analyzed using one-way and independent one-way analysis of variance statistical tests. Results: Among 100 isolates related to urinary tract infection, 33 isolates indicated resistance to at least 4 antibiotics, the highest resistance to cefotaxime antibiotic (38%) and the least antibiotic resistance to cotrimaxazole (22%). The results of combined disk indicated that 10 isolates (86.8%) were broad-spectrum β-lactamase producers. Among them, 7 isolates (70%) had the SHV gene and the other 3 isolates did not have any of the TEM and SHV genes. Conclusion: The results indicated a higher frequency of ESBLs and correspondingly a higher prevalence of antibiotic resistance in Klebsiella pneumoniae bacteria isolated from urinary tract infections.

Background and Objective: The healthy people’s fecal flora in the community represents a large potential reservoir. Therefore, the current study aimed to detect antibiotic resistance patterns and virulence factors in Klebsiella pneumoniae isolated from healthy volunteers’ feces. Materials and Methods: Three hundred and fifty stool specimens were collected from sales rep healthy individuals referring to the Northwest Tehran Health Centers to get a health card. Bacterial isolation, identification, and antimicrobial susceptibility testing were conducted according to the routine instructions. In addition, polymerase chain reaction (PCR) was used to detect the genetic factors responsible for producing extended-spectrum β-lactamases (ESBLs: SHV, TEM, and CTX-M) blaKPC and other virulence genes. Results: Among fecal samples analyzed, 60 (17.1%) K. pneumoniae were isolated. The results demonstrated that the highest resistance rate was related to piperacillin-tazobactam (n=25, 41.6%), followed by and meropenem (n=17, 28.8%) and co-trimoxazole (n=11, 18.3%), respectively. Also, all strains were susceptible to amikacin, gentamicin, and imipenem. The PCR results of the virulence gene showed that 95% (n=57) of isolates were positive for fimH gene, 93.33% (n=56) for BssS gene, 27 (45%) for rmpA gene. The PCR results for antibiotic resistance genes showed that 41.66% (n=25) had blaTEM gene, 38.33% (n=23) blaCTX-M gene, 35% (n=21) blaSHV gene and 3.33% (n=2) isolates had blaKPC gene, and none of these isolates carried magA gene. Conclusion: Antibiotic resistance was common among K. pneumoniae isolated from healthy volunteers’ feces who participated in this study. Transmission of resistant bacteria and plasmids through oral-fecal sources threats to the public, which could complicate treatment options for community-acquired infections caused by K. pneumoniae.

Introduction: Klebsiella pneumoniae is a human opportunistic pathogen. Biofilm formation is one of the important properties of this bacteria that leads to the development of multidrug-resistant phenotypes. In recent years, Nanoparticle Technology (NP) has been an important field in a wide range of studies. In this study, the effects of chemical nanoparticles on biofilm formation and antibiotic resistance of Klebsiella pneumoniae were investigated. Materials and methods: Overall, 340 samples from patients were collected from different hospitals in Tehran. Colonies were tested to identify bacteria based on standard techniques. In each bacterium, the presence of important biofilm formation genes in Klebsiella pneumoniae was detected by Multiplex PCR and their expression levels were analyzed using the Real-time PCR method. The effect of chemical nanoparticles of iron oxide on biofilm formation and antibiotic resistance was also investigated. Results: Sixty isolates of Klebsiella pneumoniae were identified based on standard techniques. The results showed that both types of iron oxide nanoparticles had a significant effect on inhibiting the formation of biofilm and antibiotic resistance of this bacterium (p

Background and purpose: Antibiotic resistance of Klebsiella pneumoniae to quinolones is a serious concern in treatment of nosocomial infections. There are limited reports on the prevalence of plasmid-mediated quinolone resistance genes in K. pneumoniae clinical isolates from Iran. The aim of this study was to investigate the rate of resistance to fluoroquinolone antibiotics, and also the frequency of qnrA, qnrB, and qnrS genes among K. pneumoniae isolates collected from hospitalized patients in Sari, Iran. Materials and methods: In this descriptive cross-sectional study, bacterial isolates were identified by conventional methods and biochemical tests. Resistance to fluoroquinolone antibiotics was evaluated by disk diffusion method. After resistance assessment, amplification of qnrA, qnrB, and qnrS genes in isolates was performed by polymerase chain reaction (PCR). Results: We analyzed 90 isolates and the antibiotic resistance of fluoroquinolone included: nalidixic acid (55%), ciprofloxacin (36%), ofloxacin (31%), levofloxacin (29%), and norfloxacin (22%). The PCR showed that 47 (52%), 22 (25%), and 21(23%) isolates harbored qnrB, qnrA, and qnrS genes, respectively. Conclusion: The outbreak of plasmid-mediated quinolone resistance (PMQR) leads to expand and increases bacterial resistance to fluoroquinolones. Therefore, continuous monitoring of antibiotic sensitivity patterns of K. pneumoniae strains to these agents is necessary.

Background: the aim of this study was the isolation of phages able to lyse some strains of MDR-K. pneumoniae (named vB_Kp1 and vB_Kp2) and E. aerogenes (named vB_Ea1) from swages. Materials and Methods: Different Klebsiella pneumoniae and Enterobacter aerogenesis strains isolated from clinical specimens (January to September 2018) in three Hospitals in Amol, (Mazandaran, Iran). Kirby Bauer’s disc diffusion method was used for determination of resistance profiles of these isolates using different antibiotics. The resistant strains to multi tested antibiotics (MDR) were selected to investigate the effect of isolated phages from wastewater and hospital sewage. Presence of phage investigated by plaque formation and after enriching and concentrating the isolated bacteriophages and staining the samples, a transmitting electron microscope (TEM) was used to observe the morphology of the bacteriophages. Phage identification tests including host range and One-step growth were performed. Results: TEM analysis revealed that tree phages have an icosahedral capsid and long contractile tail. Therefore, they are a member of the Myoviridae family. Phages were able to lyse 14 (56%) of the 25 strains of multidrug-resistant bacteria isolated. The one-step growth curve showed large burst sizes and short latent times. Conclusions: The formation of clear plaques shows the high lyse power of phages, so they have good potential for further analysis for clinical use as a therapeutic agent in the future.

Introduction Biofilm can be called a bacterial community that often forms on living or non-living surfaces and is common in natural, industrial, and hospital environments. Klebsiella pneumoniae as a pathogen has the potential to produce biofilms. Understanding biofilm formation in biofilm-forming bacteria is important. The aim of this study was to investigate the biofilm formation in isolates of Klebsiella pneumoniae from urinary tract infections of Samen Al-Aeme Hospital in Bojnourd using two phenotypic methods: Concord agar and tube turbidity. Materials and Methods The present study examined 30 samples of positive cultures with Klebsiella pneumoniae isolation from patients with urinary tract infections referred to Samen Al-Aeme Hospital in Bojnourd. Biochemical tests such as gram stain, urea, simon citrate, and TSI were performed to confirm the isolates. Isolations for biofilm formation were investigated by the Congo Red Agar method and tube testing. Results In this study, 50% of the isolates had strong biofilm and 16.66% had moderate biofilm. Also, in the turbidity method, 33.33% of the pipes had strong biofilm and 40% had medium biofilm. Conclusion In the two methods studied, the studied isolates were able to produce biofilm. Due to the production of biofilm in bacteria and its importance in pathogenesis and increasing bacterial resistance against common antibiotics, it is very important to study the production of biofilm.

Background and purpose: Ventilator-associated pneumonia (VAP), is the most common nosocomial infection in intensive care unit patients. The aim of this study was to compare common bacteria causing VAP between children and adults admitted to intensive care unit in Bahonar Hospital, Kerman 2019. Materials and methods: In a cross-sectional study, the records of both pediatric and adult patients (n=146) with ventilator-associated pneumonia in intensive care unit were investigated. Broncho alveolar lavage samples were taken from all patients and examined for presence of operating bacteria. Results: The mean ages of children and adults were 11.2±5.5 and 53.8±19.3 years, respectively (P= 0.00). Mean durations of ventilation in children and adults were 12.2±8.14 and 17.7±15.3 days, respectively. The mean time interval between ventilation and infection was not statistically significant between the two groups (P= 0.1). The length of hospital stay was shorter in pediatric group (27.5±20.5) than that in adults (40.7±23.4) (P=0.00). Acinetobacter spp. (40%) was the most common organism in both groups. Most patients in both children and adults were recovered and discharged. Conclusion: In cases with clinical and laboratory symptoms of VAP, similar antibiotic treatment was performed and the reason for hospitalization and type of underlying disease appear to be effective on treatment outcomes. [ABSTRACT FROM AUTHOR]

Background and Aim: Antibacterial effects of Artemisia plant and algae have been confirmed. The purpose of this study was to evaluate the antibacterial effect of antibiotics, Spirulina blue-green algae and Artemisa aucheri leaf extracts on multidrug resistant (MDR) Klebsiella pneumoniae. Materials and Methods: Disk and well diffusion method, the growth minimum inhibitory and bactericidal concentrations (MIC and MBC) were used to evaluate antibacterial effects. Using SPPS 16 soaftware, data were analyzed by analysis of variance (ANOVA) with repeated measures and Bonferroni test (p≤0.001). Results: The MIC and MBC for amikacin, colicitin, ceftazidime were 4 and for gentamicin and nalidixic acid were 2 and 1 µg/µl, respectively. In disk and well diffusion methods, the highest growth inhibition zones belonged to ethanolic extracts (0.25 mg/ml) of Artemisia and algae. The best MIC and MBC for growth were related to ethanolic extracts of A. aucheri at the concentration of 0.15 mg/ml. The diameter of growth inhibition zone around the bacterium was directly related to the concentrations of Artemisia and Algae extracts (p = 0.000). Conclusion: Considering the beneficial antibacterial effects of Spirulina blue-green algae and A. aucheri which were confirmed in this study, extraction of the active ingredients of medicinal plants is recommended for the mass production of herbal medicines.

Background: In recent years, the use of medicinal plants has increased due to their lower side effects and costs compared to chemical drugs and patients' adaptation to these drugs. This study was performed to investigate the antibacterial effect of aqueous and alcoholic extract of four native medicinal plants of Gilan province against the bacterium Klebsiella pneumoniae. Materials & Methods: In this study, plant species were collected from different areas of Gilan province and extraction was performed. The antibacterial effect of the extracts was investigated by the disc diffusion method. Then, using microdilution method, the minimum inhibitory concentration of bacterial growth was determined. Results and Conclusion: The results showed that chamomile alcoholic extract with the maximum average halo diameter of 14 mm showed the best effect against K. pneumoniae. The bacterium showed resistance against the aqueous and alcoholic extracts of fleawort. Also, the ethanolic extracts of nettle and chamomile plants had the best antibacterial effect at 0.39 mg/ml. The minimum inhibitory concentration of aqueous extract of fleawort plant against Klebsiella pneumoniae was 12.5 mg/ml which was lower than other types of extracts. According to the results, these extracts can be used as antibacterial products in the pharmaceutical and food industries and in the treatment of infection symptoms.

Background & Objective: Klebsiella pneumoniae has received attention due to a wide range of diseases and antibiotic resistance.The resistance to fluoroquinolones in gram-negative bacteria is often due to chromosomal mutations in the gyr and par genes. This research aimed at investigating the pattern of fluoroquinolone resistance and its relation with a mutation in the parC gene among clinical isolates of K. Pneumoniae. Methods: In this descriptive-analytical study, 95 K. pneumoniae, after biochemical and molecular diagnosis, were evaluated for resistance to different antibiotics by disk diffusion agar according to CLSI recommendations and screening for ciprofloxacin-resistant isolates. Mutation in the ciprofloxacin resistance determinant region of the parC gene of K. pneumoniae resistant to ciprofloxacin was performed by PCR amplification and then amplified fragment sequencing and finally with the standard bacterial genome sequencing available at NCBI site, became BLAST through online software, Insilico, and Clustalw2. Results: The result of the antibiogram showed implies an expansion of MDR bacteria. 3.1% of isolates were resistant to all 13 antibiotics studied and 24.2% were ciprofloxacin-resistant. The highest and lowest percentages of antibiotic resistance were determined for ampicillin and amoxicillin (98.9%) and imipenem (13.6%), respectively. Sequence analysis of the parC gene showed that of 23 isolates resistant to ciprofloxacin, 16 isolates at codon 80 (I80S), one at codon 84 (E84K) were and 3 isolates also had frame-shift mutations. Conclusion: Mutations in the parC gene can be one of the major contributors to resistance to fluoroquinolones and increased MDR bacteria and nosocomial infections.

Background and Aim: Klebsiella pneumoniae is one of the most important causes of nosocomial infection which has recently received much attention due to its antibiotic resistance. The aim of the present study is the identification and sequencing of blaCTX-M genes in clinical isolates of K. pneumonia isolated from Milad Hospital in Tehran. Materials and Methods: In this descriptive cross-sectional study, first, antibiotic resistance of 100 K. pnuemoniae isolates to cephalosporins was performed by agar diffusion method; then blaCTX-M group2 and blaCTX-M group9 resistance genes were identified by PCR. Genotyping was performed based on the sequence of these genes and the dendrogram was drawn using the Mega 6 software (version 6). Results: According to the antibiotic sensitivity testing, the amount of resistance to cephalosporins was between 30 and 54 percent. Overall, 5% of isolates had blaCTX-M group2 and 8% of isolates had blaCTX-M group9 as well as, the genotyping results showed that in this study bla CTX-M group2 sequence with the sequences in the global database (NCBI) had little similarity, and the blaCTX-M group9 gene sequence was similar to the bla CTX-M-14 sequence gene of E. coli. Conclusion: However, the frequency of blaCTX-M genes was low in this study, but due to the ability of these genes to spread by mobile genetic elements among enterobacteriaceae, it is considered alarm in the development of drug resistance among K. pneumoniae.

Background: Klebsiella pneumoniae is a gram-negative pathogen and common cause of nosocomial infections. Increasing the emergence of multi-drug resistance in Klebsiella pneumonia has limited therapeutic options for this bacterium. The aim of this study was to molecular identification of TEM and CTX genes in Klebsiella pneumoniae isolated from clinical samples of hospitals in Iranshahr city. Materials and Methods: 50 strains of Klebsiella pneumoniae within 6 months, were collected from patients admitted to the intensive care unit of hospitals in Iranshahr. The isolates were identified as Klebsiella pneumoniae based on biochemical tests. Antibiotic susceptibility test was performed by disc diffusion method. To molecular identification of TEM and CTX genes, PCR was performed. Results: Based on the results of PCR, 43 (86%) of the samples had phenotypic ESBL enzymes, 20 (47%) had CTX gene, 8 (18%) had TEM gene, and 15 (34%) had Both the CTX and TEM genes. Conclusion: The results of this study showed a high prevalence (P

Background and Objectives: Klebsiella pneumonia is a facultative anaerobe bacterium from enterobacteriaceae family, which causes a wide range of diseases, such as urinary tract infections, cystitis, pneumonia, surgical wounds infections, infectious endocarditis, and diffused infections, especially in patients with HIV infection and immunosuppression. The aim of this study was to identify carbapenem resistance genes in K. pneumonia strains isolated from hospitalized patients in Qom city. Methods: In this cross-sectional study, using phenotypic methods, such as DDST and Modified Hodge Test, 79 carbapenem resistant isolates were identified and presence of resistance related genes, including IMP, VIM, NDM, OXA-48 and KPC, was investigated by molecular methods, such as PCR. Relation between the results of phenotypic and PCR methods, was determined using Chi squared test. Results: In this study, 69 isolates had IMP, VIM, NDM, OXA-48, and KPC genes, which the highest carbapenem resistant isolates were urinary strains and the lowest resistant was from cerebrospinal fluid samples. The most frequent isolated gene was VIM with 66.66% frequency, and KPC and NDM genes had lowest frequency with of 7.24%. One isolate contained all studied genes. Conclusion: Considering drug-resistant infections cause failure of treatment, especially higher mortality rate in patients in the intensive care unit, thus, the need for a codified program for screening and reporting ESBL strains is necessary for the assessment and monitoring the treatment, as well as determining an effective guidelines for treatment of resistant infections.

Background: Klebsiella pneumoniae is an opportunistic microorganism causing nosocomial infection all over the world .This study aimed to investigate the prevalence of biofilm formation in K. pneumoniae isolated from patients and its correlation with the virulence factors. Materials and Methods: Biochemical tests were used for the identification of K. pneumonia isolated from patients referred to Motahari and Milad hospitals in Tehran, Iran, from October 2015 to June 2016. Kirby-bauer test was performed and biofilm formation was assessed phenotypically. Finally, virulence genes were detected by the PCR method. Results: The highest resistance rate was against ceftazidime and cefotaxime (67%) and the least resistance rate was against imipenem and meropenem (39%). In addition, 81% of the isolates were biofilm producers according to the results of biofilm formation assay. Also, the results of PCR showed that all 57 biofilm producer isolates harbored fimA, mrkA, ecpA, and fimD virulence genes and 92% of these isolates harbored fimH virulence gene. Among non-biofilm producer isolates, 36% had fimA gene, 29% had ecpA gene, and none of these isolates carried mrkA and fimH genes. Conclusion: It seems that antibacterial resistance has a significant association with biofilm formation in K. pneumoniae isolates. Therefore, understanding resistance pattern and mechanisms leading to biofilm formation can facilitate efficient treatment of infections caused by this bacterium

Background: Klebsiella pneumoniae is a germ-negative pathogen and a common cause of nosocomial infections. Increasing the emergence of multi-drug resistance in Klebsiella pneumonia has limited therapeutic options for this bacterium. The purpose of this study was to evaluate the effect of iron nanoparticles on expression of TEM and SHV genes in Klebsiella pneumoniae isolated from clinical samples using Real- Time PCR. Materials and Methods: A total of 50 strains of Klebsiella pneumoniae were collected from patients admitted to the intensive care unit of hospitals in Kerman on 6 months. The isolates were identified as K. pneumoniae, based on the biochemical tests embedded in the API-20E system. Antibiotic susceptibility test was performed by disc diffusion method. For molecular identification of TEM and SHV genes, PCR was performed. To determine the effect of iron nanoparticles on the strains, a dilution broth method was used according to CLSI standard and finally, Real-Time PCR was performed. Results: In this study, 46 isolates were positive for ESBL producing phenotypes. In the 46 isolates of ESBL producing, 48% (22 cases) had the SHV gene , 13% (6 cases) had the TEM gene and 39% (18 cases) had both SHV + TEM genes. Iron nanoparticles could degrade the expression of TEM and SHV genes in the clinical medium in Klebsiella pneumoniae. Conclusion: Due to the effectiveness of iron nanoparticles on positive beta-lactamases Klebsiellas, can use iron nanoparticles as a medicine dose.

Background and Objectives: Acquisition of AmpC β-lactamase enzymes is one of the important factors in the resistance of Klebsiella pneumoniae to β-lactam antibiotics. The purpose of this study was to determine the antibiotic resistance, phenotypic frequency of AmpC, and detection of MOX, CIT, DHA, ACC, EBC, and FOX genes in K. pneumoniae strains isolated from medical centers in Kermanshah. Methods: In this descriptive cross-sectional study, 100 suspected cases of K. pneumoniae, were collected from 2013 to 2015 from patients referring to three hospitals and one laboratory in Kermanshah city. antimicrobial susceptibility disk diffusion test and AmpC phenotypic screening test, were performed using boronic acid combination method, and after extraction of bacterial genome, AmpC genes were identified by multiplex PCR method. Results: Resistance to third generation cephalosporins, was 70%, and resistance to aztreonam was reported 65%. The highest and the lowest resistance was to ampicillin (98.5%) and carbapenems (less than 10%), respectively; 27.1% of the isolates phenotypically produced AmpC and a high percentage of isolates from the infectious ward and intensive care unit (ICU) was AmpC producer. The frequency of MOX, CIT, FOX, and DHA genes was obtained to be 11.4%, 10%, 2.8%, and 1.4%, respectively. However, EBC and ACC genes, were not found in any of the isolates. Conclusion: The results of this study showed that phenotypic tests alone are not sufficiently accurate in the evaluation of AmpC enzymes. Therefore, simultaneous use of genotypic methods is necessary. In this study, the high prevalence of AmpC genes, especially MOX and CIT in K. pneumoniae isolated from infectious and ICU wards in Kermanshah hospitals is indicative of importance of dissemination of this group of β-lactamase enzymes.

Introduction: The wideuse of beta-lactam antibacterial agents in the treatment of bacterial infections has increased bacterial resistance. Nowadays, one of the problems in the treatment of nosocomial infections is enzymes resistance to broad spectrum beta-lactamases among clinical isolates, especially Klebsiella pneumoniae.Over the past decade, CTX-M type enzymes have been recognized asthe most common type of broad-spectrum beta-lactamase in Europe, Canada, and Asia.The aim of this study was to evaluate the prevalence of broad-spectrum beta-lactamase-producingKlebsiella pneumoniae bacteria and to identify the CTX-M-3 gene by molecular method. Materials & Methods: Over a 9-month period, 130 Klebsiella pneumoniaewere isolated from different clinical specimens (urine, blood, ulcers) of infectious patients in Imam Khomeini Hospital, Sari, Iran. Their susceptibility to nine antibiotics used for gram-negative bacteria was measured by disk diffusion agar method. The extended-spectrum beta-lactamases (ESBLs) producing isolates were identified using a hybrid disc method. Moreover, strains producing CTX-M-3 enzyme were detectedby polymerase chain reactionmethod. Findings: The 48 (36.8%) isolates of Klebsiella pneumoniaewere the producer of ESBLs. Moreover, 22 (16.9%) of these cases contained the CTX-M-3 gene. Discussion & Conclusions: The obtained results of the currentstudy showed that the prevalence of ESBL producing strains resistant to quinolones is higher in Iran, compared to the developed countries.

Background and Objective: Klebsiella pneumoniae is known as one of the opportunistic pathogens. The prevalence of antibiotic resistance, emergence of multidrug resistant strains, and multiple virulence factors contribute to the development of various infections. In this regard, the aim of this study was to evaluate the frequency of fimH, magA, and rmpA genes among Klebsiella pneumoniae isolates in hospitalized patients from Babol, Iran. Materials and Methods: In this descriptive cross-sectional study, 65 Klebsiella pneumoniae strains were collected. In the present study, antibiotic resistance pattern was performed using disc diffusion method. After DNA extraction by a commercial kit, the frequency of magA, fimH, and rmpA genes was evaluated by polymerase chain reaction. Results: A total of 65 strains was collected from Rouhani (n=42) and Shahid Beheshti (n=23) Hospitals. Based on the antibiogram pattern, the highest resistance rate belonged to erythromycin (61.5%) and cefotaxime (60%) and the lowest resistance rates belonged to imipenem (0%) and ofloxacin (16.9%). Furthermore, in the molecular method, the frequency of fimH and rmpA genes was reported 86.1% and 10.8%, respectively. It should be noted that none of the strains harbored the magA gene. Conclusion: Based on the results of the present study, antibiotic resistance and multidrug resistance strains among Klebsiella pneumoniae strains are increasing. On the other hand, the presence of some virulence factors can play a significant role in the development of resistant strains.

Introduction: So-called biofilm or biomass is interacting cells or microorganisms that accumulate together as a result of various factors on a surface. Biofilm formation increases resistance to unfavorable conditions and biocides. Of the strategies to deal with biofilms is using different plant compounds and nanoparticles. The aim of this study was to determine the effect of silver nanoparticles, lavender extract, and their combined effects in different concentrations on Klebsiella pneumoniae biofilm. Materials & Methods: The anti-biofilm effect and reduced rate of biofilm formation of Klebsiella pneumoniae in separated and combined treatments of stoechas extract (Lavandula stoechas) and silver-nanoparticles at 24, 48 and 72 hours were measured by colorimetric microtiter method. Phenolic content was also measured by Folin-Ciocalteu method. Findings: Phenolic content was about 113.3 mg/g. In the absence of treatments, Klebsiella was able to form strong biofilms. Three-way-analysis of variance of the main and interacting effects of silver nanoparticles, lavender extract and time on biofilm formation was significant. Silver nanoparticle and lavander extract at concentrations of 125 and 0.0625 ug/mL, respectively, and co-treatments at 62.5 and 0.03125 ug/mL concentrations, respectively, significantely reduced biofilm formation. Discussion & Conclusions: By increasing time, biofilm formation reduced due to effects of treatments. Biofilm formation also reduced by increasing concentration of the treatments. The result of this survey showed that silver-nanoparticles and lavender extract have synergistic effects on reduction of biofilm formation.

Background & Aim: Klebsiella pneumoniae is one of the most common gram-negative bacteria in the development of nosocomial infections, in particular urinary tract infections, which has been resistant to antibiotics in recent years. The aim of this study was to determine the pattern of antibiotic resistance in the most common capsule types of this bacterium in Zarinshahr city of Isfahan. Material and Methods: 29 strains of Klebsiella pneumoniae isolated from urinary tract infections in patients admitted to different parts of Zarinshahr Hospital in summer 2016 to summer 2017 were selected. After confirmation of phenotypic and genotype and determination of capsule types in them, antibiotic resistance pattern in isolates was determined using Kirby-bauer method, according to the CLSI standard, on the Muller Hinton Agar, 13 antibiotics were determined. Frequency of antibiotic resistance gene encoding genes including tetA, cmlA, Cat1, blaSHV, sul1, aac (3) -IV, aadA 1, qnr CITM, dfrA1, and tetB genes in isolates was determined by PCR method. Results & Conclusion: Serotype K2 with 74.51% frequency was the most commonly known capsule serotype known in isolates. All isolates had multiple antibiotic resistance and in addition to penicillin, their antibiotic resistance was the highest (10.93%) and tetracycline (44.30%) respectively. The tetA and sul1 genes with the frequency of 86.75% and 41.72% were the most common, and the two cat1 and cm1A genes with a frequency of 89.60% and 44.10% were the least common antibiotic resistance genes in Klebsiella pneumoniae strains isolated from urinary tract infections.

Background and Aims: Klebsiella pneumoniae that causes bloodstream and urinary tract infections has several virulence factors encoding genes. Factors like the ability of adherence to the host cell surface, presence of sidrophore receptors and regulation of mucoid phenotype are the common virulence ones involved in the pathogenesis of K. pneumoniae. The aim of this study was to determine the frequency of virulence factor encoding genes in K. pneumoniae isolates, collected from hospitalized patients by Multiplex PCR. Materials and Methods: In this descriptive study, the frequency of genes encoding virulence factor irp2, wcaG, rmpA, rmpA، allS and fimH were evaluated in 100 K. pneumoniae isolates, collected from patients referred to teaching hospitals of Zahedan city by Multiplex PCR. Results: Among 100 clinical isolates of K. pneumoniae, allS gene had the highest frequency, 90%, and rmpA had the lowest frequency, 6%. The frequency of genes fimH, irp2, wcaG and rmpA were 88%, 87%, 33% and 6% respectively. Conclusions: The results of this study showed that the allS, irp2 and fimH genes were more frequent among K. pneumoniae isolated from studied patients in Zahedan city. These findings provide important information on the importance of these virulence factors on pathology of urogenital tract infection, management of Klebsiella infection and success of treatment strategies.

Background and Objective: According to the high incidence of Klebsiella pneumoniae nosocomial infections in different wards of health care units and the emergence of high levels of antibiotic resistance, evaluating the frequency of multi-drug resistant strains and recognizing the virulence factors may help treat the related infections. Materials and Methods: In this descriptive cross-sectional study, by presenting to the laboratories of Rouhani and Shahid Beheshti hospitals of Babol (Iran) during six months, Klebsiella pneumoniae strains were isolated from clinical specimens and transferred to the microbiology laboratory of Babol University of Medical Sciences for confirmation. Afterwards, the antibiotic resistance pattern was identified by disc diffusion method for the following antibiotics: amoxicillin, erythromycin, cefotaxime, gentamicin, ciprofloxacin, piperacillin, cefixime, amikacin, and imipenem. Finally, after DNA purification by using a commercial kit, mrkD and Kpn genes were evaluated by PCR molecular test. Results: Sixty Klebsiella pneumoniae strains were isolated from different clinical specimens during six months. By using disc diffusion method, the highest (95.4%) and lowest (0%) resistance rates pertained to amoxicillin and imipenem, respectively. The frequencies of mrkD and Kpn genes were 71% and 63%, respectively. Conclusion: Due to the high prevalence of antibiotic resistance among Klebsiella pneumoniae strains and considering that this is the first report of the mentioned genes in Babol, it is necessary to adopt appropriate therapeutic regimens to reduce antibiotic resistance.

Background: In recent years, the use of medicinal plants has increased due to their lower side effects and costs compared to chemical drugs and patients' adaptation to these drugs. This study was performed to investigate the antibacterial effect of aqueous and alcoholic extract of four native medicinal plants of Gilan province against the bacterium Klebsiella pneumoniae. Materials & Methods: In this study, plant species were collected from different areas of Gilan province and extraction was performed. The antibacterial effect of the extracts was investigated by the disc diffusion method. Then, using microdilution method, the minimum inhibitory concentration of bacterial growth was determined. Results & Conclusion: The results showed that chamomile alcoholic extract with the maximum average halo diameter of 14 mm showed the best effect against K. pneumoniae. The bacterium showed resistance against the aqueous and alcoholic extracts of fleawort. Also, the ethanolic extracts of nettle and chamomile plants had the best antibacterial effect at 0.39 mg/ml. The minimum inhibitory concentration of aqueous extract of fleawort plant against Klebsiella pneumoniae was 12.5 mg/ml which was lower than other types of extracts. According to the results, these extracts can be used as antibacterial products in the pharmaceutical and food industries and in the treatment of infection symptoms. [ABSTRACT FROM AUTHOR]

Background: Klebsiella pneumoniae has received attention due to a wide range of diseases and antibiotic resistance.The resistance to fluoroquinolones in gram-negative bacteria is often due to chromosomal mutations in the gyr and par genes. This research aimed at investigating the pattern of fluoroquinolone resistance and its relation with a mutation in the parC gene among clinical isolates of K. pneumoniae. Materials & Methods: In this descriptive-analytical study, 95 K. pneumoniae, after biochemical and molecular diagnosis, were evaluated for resistance to different antibiotics by disk diffusion agar according to CLSI recommendations and screening for ciprofloxacin-resistant isolates. Mutation in the ciprofloxacin resistance determinant region of the parC gene of K. pneumoniae resistant to ciprofloxacin was performed by PCR amplification and then amplified fragment sequencing and finally with the standard bacterial genome sequencing available at NCBI site, became BLAST through online software, Insilico, and Clustalw2. Results: The result of the antibiogram showed implies an expansion of MDR bacteria. 3.1% of isolates were resistant to all 13 antibiotics studied and 24.2% were ciprofloxacin-resistant. The highest and lowest percentages of antibiotic resistance were determined for ampicillin and amoxicillin (98.9%) and imipenem (13.6%), respectively. Sequence analysis of the parC gene showed that of 23 isolates resistant to ciprofloxacin, 16 isolates at codon 80 (I80S), one at codon 84 (E84K) were and 3 isolates also had frame-shift mutations. Conclusion: Mutations in the parC gene can be one of the major contributors to resistance to fluoroquinolones and increased MDR bacteria and nosocomial infections. [ABSTRACT FROM AUTHOR]

Background and Aims: Klebsiella pneumoniae is one of the most common causes of nosocomial infections. The aim of this study was to determine the frequency of the blaTEM and blaSHV genes in K. pneumoniae strains isolated from blood samples of neonates admitted to some health centers in Rasht. Materials and Methods: In this study, 163 isolates from blood samples were taken during 6 months from July to December 2015. Antibiotic susceptibility was conducted by disc diffusion method and screening test using combination disc method. Also, the presence of blaTEM and blaSHV genes were studied using PCR method. Results and Conclusions: Among the total of 163 cultured blood samples, 16 were positive. Only 3 strains were diagnosed as K. pneumonia (18.75%). Two out of 3 positive samples (67%) were identified as the ESBLproducers in the primary screening test. The isolated K. pneumonia had the highest resistance to penicillin and amoxicillin (100%) and the lowest resistance to imipenem and ceftazidime (33%). The results of PCR on 3 samples showed that all the 3 isolates (100%) contained SHV gene, 1 strain (33.3%) had TEM gene and 1 case (33.3%) had both TEM and SHV genes simultaneously. In conclusion the horizontal gene transfer among bacteria in hospitals and clinical centers and the patterns of antibiotic useage should receive more attention.

Background & objectives: One of the main problems in the control of nosocomial infections due to Klebsiella pneumoniae is increase of antimicrobial resistance and prevalence of extended spectrum β-lactamase (ESBLs) producing isolates. The aim of this study was to investigate the correlation of antibiotics resistance with SHV, CTX-M and TEM extended-spectrum beta lactamases genes among Klebsiella pneumoniae isolates isolated from the patients in Kermanshah hospital. Methods: The clinical isolates of Klebsiella pneumoniae were collected during the spring from Kermanshah hospitals, and identification of Klebsiella pneumoniae strains was performed using standard microbiological and biochemical tests. Antibiotic resistance of Klebsiella pneumoniae isolates was determined using disk diffusion method. Then, the presence of CTX-M, SHV, and TEM was investigated using multiplex-PCR method. Finally, the relationship between variables was analyzed by SPSS-22 software using logistic regression and chi-square. Results: A total of 98 isolates out of 112 samples were identified as Klebsiella pneumonia. Also, 82.8% of isolates were resistant to cefotaxime, 40.2% to ceftriaxone, 62.88% to ceftazidime, 3.9% to imipenem, 39.17% to cefepime, 64.94% to cefixime and 26.8% to amikacin. Further, 35.55% of isolates had CTX-M gene, 63.91% of isolates had SHV gene and 9.27% of samples had TEM gene. Conclusion: The presence of CTX-M, SHV and TEM genes along with high antibiotic resistance are very concerning, indicating the importance of rational use of antibiotic for the treatment of infectious diseases.

Background and Aim: Klebsiella pneumoniae is one of the most important causes of nosocomial infection which has recently received much attention due to its antibiotic resistance. The aim of the present study is the identification and sequencing of bla CTX-M genes in clinical isolates of K. pneumonia isolated from Milad Hospital in Tehran. Materials and Methods: In this descriptive cross-sectional study, first, antibiotic resistance of 100 K. pnuemoniae isolates to cephalosporins was performed by agar diffusion method; then bla CTX-M group2 and bla CTX-M group9 resistance genes were identified by PCR. Genotyping was performed based on the sequence of these genes and the dendrogram was drawn using the Mega 6 software (version 6). Results: According to the antibiotic sensitivity testing, the resistance to cephalosporins was between 30 and 54 percent. Overall, 5% of isolates had bla CTX-M group2 and 8% of isolates had bla CTX-M group9 as well as, the genotyping results showed that in this study bla CTX-M group2 sequence with the sequences in the global database (NCBI) had little similarity, and the bla CTX-M group9 gene sequence was similar to the bla CTX-M-14 sequence gene in E. coli. Conclusion: However, the frequency of bla CTX-M genes was low in this study, but due to the ability of these genes to spread by mobile genetic elements among enterobacteriaceae, it is considered alarm in the development of drug resistance among K. pneumoniae isolates. [ABSTRACT FROM AUTHOR]

In the current study, the effect of seasonal variation on the type and percentage of pHytochemical compounds of Artemisia fragrans Willd. essential oil was investigated. Herbal samples were collected in 4 different seasons and then their essential oils were extracted by the Clevenger type apparatus. In the following, the essential oil compositions of each season was analyzed by GC-MS apparatus. In total, 50 different compounds were identified in four sentential oil. The major components of the essential oil were camphor, thujone, and 1,8-cineole in different seasons. Also, the results showed that monotreptans were the major class of essential oil compounds in September (91.87%), December (90.55%), May (96.32%) and July (95.4%). The highest amount of phenolics (5.49 mg GAE/g) and antioxidant capacity (28.98%) were observed in essential oil of Septebmer. Antibacterial effects of the different essential oils using paper disc diffusion method were carried out on Escherichia coli, Proteus vulgaris, Klebsiella pneumonia, Staphylococcus aureus, and Bacillus subtilus. Based on the results of the study, gram negative bacteria (E. coli, Proteus vulgaris, and K. pneumonia) were more susceptible to artemisia essential oils in comparison with gram positive bacteria (S. aureus and B. subtilus). The results of this research can be useful in determining the best sampling date of this plant for pharmaceutical and antibacterial uses. [ABSTRACT FROM AUTHOR]

Background: Extended-spectrum beta-lactamases (ESBL) producing isolates of Klebsiella pneumoniae which have been increased in the hospitals were resulting in limitation of therapeutic options. The aims of this study were to evaluate the antibiotic susceptibility pattern and presence of ESBL genes in clinical isolates of Klebsiella pneumoniae from patients admitted to the intensive care units (ICUs). Materials and Methods: In this descriptive cross-sectional study, a total of 65 Klebsiella pneumoniae strains were isolated from ICUs of educational hospitals in Tehran. Identification was performed using biochemical tests and the antimicrobial susceptibility was performed as recommended by the Clinical and Laboratory Standards Institute (CLSI). Molecular analysis of the ESBL genes was performed by Multiplex PCR (M-PCR). Results: Most of the isolates were resistant to Cotrimoxazole (72.3%), Gentamicin (67.7%) and Ampicillin (69.2%) and the highest susceptibility was seen for Ciprofloxacin (50.8%) Tetracycline (49.2%), Imipenem (46.3%) and Ceftriaxone (43.1%). Among the ESBL-producing genes, blaCTX-M (55.3 %) was the most prevalent, followed by blaTEM (41.5 %) and blaSHV (10.7 %). The results showed that 1.5 % of the isolates had concurrently blaTEM/ blaSHV and blaSHV/ blaCTX-M genes and 21.6% of isolates the blaTEM/ blaCTX-M genes. Conclusion: These findings reveal the high prevalence of multi drug resistant and ESBL-producing Klebsiella pneumoniae in patients hospitalized in ICUs and emphasize the need for appropriate infection control policies.

Introduction: Progress in nano-science and nanotechnology in the past decade has provided many opportunities to study the biological effects of nanoparticles, in particular their anti-bacterial effects. The aim of this study was to evaluate the antimicrobial properties of silver nanoparticles for the removal of Klebsiella pneumoniae isolated from industrial effluents. Methods: In this experimental study, after sampling polluted industries, coliform and total coliform measurements of fecal industrial wastewater microbiology were performed by standard methods. The antimicrobial activity of silver nanoparticles on the bacteria (Klebsiella pneumoniae isolates and standard) was evaluated with the agar dilution method and broth dilution. One milliliter suspension containing bacteria at 1.5 × 108 CFU/mL was added to each sample followed by incubation at 37°C for 24 hours. After the mentioned period, the optical density at a wavelength of 600 nm was used to measure the concentration of bacteria. Next, 100 mL of each dilution was transferred to solid medium followed by incubation. The results were analyzed with SPSS 22 software. Results: Fecal and total coliform bacteria pollution of textile wastewater was approved, and Klebsiella pneumoniae (textile industry pollution index) were isolated. With increasing concentration, the antibacterial activity of silver nanoparticles increased while the number of colonies decreased. Although none of the concentrations were able to eliminate the bacteria, a non-significant decrease in the number of bacteria was observed. Conclusion: The results of the study showed that the type of bacteria and concentrations of silver nanoparticles antimicrobial properties of silver nanoparticles are risk factors. Although the concentrations used were effective against bacteria yet they did not lead to complete elimination of bacteria Therefore potential impact of nanoparticles for use requires further research and economic factors and other factors should be considered in their application.

Introduction: Due to the increasing trend of antibiotic resistance in the Enterobacteriaceae family, treatment of infections caused by these bacteria has been difficult. The aim of this study was to identify of class I and II integrons and associated gene cassettes in clinical isolates of Escherichia coli and Klebsiella pneumonia. Methods: In this cross-sectional study, of 500 strains isolated from clinical samples of hospitals in Hamadan, Iran, in 2015, 129 K. pneumoniae and 118 E. coli isolates were isolated and examined. Then, the isolates were verified by standard biochemical methods and PCR was performed on class I and II integron genes using specific primers. Results: The results of this study showed that the prevalence of class I integrons was more than class II integrons. The most frequent class I integron gene cassettes were aadA1 and dfrA7 respectively, which are resistance encoding genes for kanamycin and trimethoprim. Conclusions: The result of this study indicated a high prevalence of class I integrons in E. coli and K. pneumonia isolates. Thus, the identification of these resistance genes for infection control programs and to prevent the spread of resistant strains is very important

Abstract Background: The efflux pumps are one of the main mechanisms of resistance to antibiotics in E. coli and K. pneumoniae strains. The aim of this study is to study the association between genes coding efflux pumps AcrAB and Qep A and ciprofloxacin resistance among E. coli and K. pneumoniae clinical strains Materials and Methods: This study was done on 100 strains of E. coli isolated from Taleghani and Labbafinejad Hospitals and 100 strains of K. pneumoniae isolated from Taleghani and Mofid Children Hospitals. Antimicrobial susceptibility tests were performed by disk diffusion method based on CLSI guidelines. Identification of genes encoding efflux pumps Acr AB and Qep A was done by PCR technique. Results: In this study, fosfomycin and imipenem had the best effect against E. coli clinical isolates and fosfomycin and tigecycline had the best effect against K. pneumoniae clinical isolates. PCR assay demonstrated that the prevalence of AcrA, AcrB and QepA genes among E. coli isolates were 92%, 84% and 0%, respectively and among K. pneumoniae isolates were 94%, 87% and 4%, respectively. Conclusion: The prevalence of genes encoding efflux pumps in E. coli and K. pneumoniae clinical strains, which causes resistance to fluoroquinolones, is cause for concern. Therefore, controlling infection and preventing the spread of drug-resistant bacteria needs to manage medication carefully and identify resistant isolates.

Background and Aim: within recent 15 years, extended spectrum beta lactamase (ESBL) positive agents have caused many infections which could be a serious threat to the antibiotic therapy. The aim of this study is to compare the effect of antibiotics and Cell Free Supernatant (CFS) of Lactobacillus spp. culture on the survival of K. pneumoniae ESBL positive isolates that cause nosocomial infections. Methods and Materials: The antibiograms were determined for 7 K. pneumoniae clinical isolates (expressing CTX-M, TEM and SHV beta-lactamases) according to Kirby-Bauer method. Minimum Inhibitory Concentration and Minimum Bactericidal Concentration for selected antibiotics were determined according to CLSI guidelines. In order to evaluate the effect of Lactobacillus acidophilus, L. casei, L. fermentum, L. plantarum and L. rhamnosus’ CFS on K. pneumoniae isolates, well-diffusion method, MIC and MBC determination were used. To determine the probable effective agent of CFS on inhibition of K. pneumoniae growth, CFS were neutralized and evaluated again according to MODA method. Results: All K. pneumoniae isolates were resistant to gentamicin, cephalothin, ceftazidime and ciproflpxacin. The CFS of L. plantarum and L. rhamnosus and their acidic metabolites had the most antimicrobial effect. Conclusion: Functional disorder would occur through enzymes inactivation and increasing cell membrane permeability by the effect of acidic metabolites of CFS, while K. pneumoniae isolates became resistant to some antibiotics with specific site of action. Therefore, CFS of Lactobacillus spp. could be an appropriate alternative for selected antibiotics against these K. pneumoniae isolates.

Abstract Background: The dissemination of extended-spectrum β-lactamases (ESBL) in Klebsiella pneumoniae isolates has resulted in the increase of antibiotic resistance and mortality among patients. The aim of this study was to determine the prevalence of ESBL and SHV-2a, SHV-5 and SHV-12 genes in K. pneumoniae isolates from Kermanshah. Materials and Methods: In this descriptive – analytical study, from 112 clinical samples of patients admitted at Kermanshah medical centers in 2014, 60 K. pneumoniae isolates were recognized by standard methods of bacteriology and API Kit. Antibiotic susceptibility of isolates was determined by disk diffusion method and the isolates were screened for ESBL-producerig using the combination disc method. The SHV-2a, SHV-5 and SHV-12 genes were determined among isolates using PCR method. Primers were designed in this study. Results: Of 60 isolates tested, the highest and the lowest resistance was for ampicillin and carbapenem antibiotics, respectively. Forty-five percent of isolates were ESBL-producer. Among 60 isolates tested, 5 (8.3%), 57 (95%) and 43 (71.7%) isolates contained SHV-2a, SHV-5 and SHV-12 genes, respectively. Five isolates contained all the three genes of SHV-2a, SHV-5 and SHV-12. Conclusion: The results indicate the relatively high prevalence of SHV type beta-lactamase genes in K. pneumoniae isolates in Kermanshah. Given this high prevalence, the surveillance of antibiotic resistant patterns and relevant genes is necessary among gram-negative bacilli in Kermanshah region. Due to the high resistance of K. pneumoniae isolates to antibiotics and to reduce the dissemination of resistant genes, susceptibility testing to choose more affective antibiotics is recommended even for isolates from outpatients.

Background and Aim: Klebsiella pneumoniae is a member of the Enterobacteriaceae family. There is a global emergence of multidrug-resistant (MDR) strains of K. pneumoniae, a Gram-negative enteric bacterium that causes nosocomial and urinary tract infections. The aims of the present study were to identify the Klebsiella pneumoniae infections in hospitalized patients, characterization of blaCTX gene, detection cross-resistance and cefepime susceptible-dose dependent (SDD) in isolates. Materials and Methods: In present study, 111 strains of Klebsiella pneumoniae were isolated from patients hospitalized in Ghotbadden, Faghihi and Nemazee hospitals (Shiraz, Iran). The isolates were identified as K.pneumoniae, based on biochemical tests embedded in the API-20E system. Susceptibility testing (disc diffusion) was performed according clinical and laboratory standards institute (CLSI) guidelines. Detection cefepime susceptible-dose dependent (SDD) was performed. The detection of AmpC β-lactamases producing strains was done based on cefoxitin and cefepime disk tests. The blaCTX gene was detected in the isolates by PCR molecular method. Results: Total 111 Klebsiella pneumoniae isolates were studied. The less effective drug was ceftazidime (37.8% isolates were sensitive). All SDD strains were susceptible to colistin and imipenem. Colistin (96.4%) and imipenem (88.3%) were the most effective antibiotics against isolates. Respectively, 41.4% and 35.1% isolates displayed resistance to gentamicin and amikacin. All colistin resistant isolates were imipenem sensitive. The results of PCR on blaCTX gene showed that 70.3% of the isolates possess the gene. Conclusion: Carbapenem drugs are effective against Klebsieella pneumoniae infections. These results indicate that multidrug-resistant (MDR) and extensively drug resistant (XDR) strains of K.pneumoniae are rising, and fewer antibiotics may be useful for treating infections caused by these strains. Routine investigation and reporting of antibiotics resistance profile in patients presenting with Klebsiella infections is suggested.

Background & Objective: Klebsiella pneumonia (K. pneumoniae) is a Gram-negative enteric bacterium that causes nosocomial infections. The aims of the present study were to identify the Klebsiella pneumoniae infections in hospitalized patients: the characterization of cross-resistance and antibiotic resistance patterns in isolates and the detection of cefepime susceptible-dose dependent in strains. Materials & Methods: In the present study (during 2014-2015), samples were collected from patients hospitalized in Ghotbadden, Faghihi and Nemazee hospitals (Shiraz, Iran). The isolates were identified as K. pneumoniae, based on the biochemical tests embedded in the API-20E system. The susceptibility testing (disc diffusion) was performed according to the clinical and laboratory standards institute guidelines (CLSI 2014). The dDetection of cefepime susceptible-dose dependent (SDD) was performed. The detection of AmpC β-lactamases producing strains was done based on the cefoxitin and cefepime disk tests. Results: In this study 111 strains of Klebsiella pneumoniae were isolated. The less effective drug was ceftazidime (37.8% were sensitive). All SDD strains were susceptible to colistin and imipenem. Colistin (96.4%) and imipenem (88.3%) were the most effective antibiotics against isolates. Respectively, 41.4% and 35.1% isolates displayed resistance to gentamicin and amikacin. All colistin resistant isolates were imipenem sensitive. Conclusion: Carbapenem drugs are effective against Klebsieella pneumoniae infections. These results indicate that multidrug-resistant strains of K. pneumoniae are rising. The routine investigation and reporting of antibiotics resistance profile in patients presenting with Klebsiella infections is suggested.

Objective: Klebsiella Pneumoniae is one of the most important infection bacteria of the Enterobacteriaceae family. It is also the second factor of hospital bacteremia due to the gram negative bacteria after Escherichia coli. In this research, this bacteria with the private 16SrDNA gene, was identified through PCR-ELISA technique. Materials and Methods: In this method the dNTP labeled with Digoxigenin was used for amplifying the specific gene. Streptavidin was loaded in ELISA plate, and then the specific Biotinylated probe was used to connect the Polymerase Chain Reaction (PCR) product. Biotinylated probe was connected to the streptavidin and the amplified gene was attached to the probe. Finally, the digoxigenin antibodies were used to identify the PCR product. The reaction was measured with an ELISA reader. Result: 16SrDNA of Klebsiella pneumoniae was amplified using the gene specific primers resulted in a fragment of the bp 260. The results of PCR-ELISA showed that this technique does not cross-react with the bacteria in their families. Additionally, the sensitivity of 6.0 ng was evaluated. Conclusion: In this research, PCR-ELISA technique was known as an accurate and rapid test for the detection of infection agents by using the specific gene. PCR-ELISA can act as an alternative method instead of time-consuming, less sensitive, and expensive techniques such as culture bacteria in blood agar plates, Macconkey agar, Realtime PCR and differential biochemical tests which are currently used in the research labs.

Introduction: The gold nanoparticles as other nanoparticles have catalytic, magnetic, optical, and biological (antimicrobial) properties. On the other hand, resistance to antibiotics is one of the greatest public health problems posed in the world. Therefore, the present study aimed to investigate the antibacterial effects of gold nanoparticles on multi-drug resistant klebsiella pneumoniae as well as escherichia coli and its effect on the liver of balb/c mice. Methods: In this study, multi-drug resistant Klebsiella pneumoniae and Escherichia coli bacteria clinical samples were utilized that were isolated from several hospitals in Isfahan and then the toxic effects of nanoparticles were investigated on the Balb / C mice. Colloidal gold nanoparticles were also applied with spherical shape and a concentration of 200 ppm in size of 10 nm, using two wells and disk agar diffusion method. Antibacterial properties of the nanoparticles were evaluated within 1-3 days with 37 ˚c temperature, and diameter of inhibitory zone of growth was measured every day. Tissue and liver enzymes of the mice were examined, as well. Results: The greatest diameter of inhibitory zone was detected in multi drug resistant E. coli. Most of the MIC and MBC were found in multi-drug resistant Klebsiella pneumoniae bacteria .Gold nanoparticles did not reveal any significant changes on the weight, liver enzymes and liver tissue of Balb / C mice after one month. Conclusion: As the findings of the current study revealed, inhibitory effect of gold nanoparticles was observed on the axamined microorganism. Although the laboratories findings are promising, more studies should be conducted in regard with therapeutic standardization.

Background: Antimicrobial resistance is a growing problem in many bacterial pathogens and is of particular concern for hospital-acquired nosocomial infections. Klebsiella pneumonia is an important cause of nosocomial infections has rapidly become the most common extended spectrum beta-lactamases (ESBLs) producing organism. ESBL are defined as the enzymes capable of hydrolyzing oxyimino-cephalosporins. The aim of this study was to compare phenotypic detection of ESBL using two phenotypically method among the clinical isolates of Klebsiella pneumoniae. Methods: In this cross-sectional study a total of 144 isolates from clinical samples Urine, sputum, wound, blood, throat and body fluids isolated and identified as K. pneumoniae in a teaching hospitals in Shiraz within a six months period from December 2012 to May 2013. Antibacterial susceptibility test performed to 14 antibiotics by the disk diffusion method according to CLSI guideline and then isolates that were resistant to at least one of the beta-lactam antibiotics evaluated for the production of beta-lactamase enzymes by using E-test ESBL and combined disk method. Results: Totally 38 (26.3%) isolates produced ESBLs. All ESBL producing isolates were susceptible to imipenem and meropenem and resistant to aztreonam. The highest antibiotic resistance was observed for amoxicilin (100%) and the lowest antibiotic resistance was observed for meropenem (9.7%). The number of 38 (100%) isolates were identified as ESBL producer by using E-test ESBL ceftazidime. It was while using the combined disks; ceftazidime/clavulanic acid, cefotaxime/clavulanic acid and cefpodoxime/clavulanic acid, respectively 35 (92.1%), 34 (89.4%) and 31 (81.5%) of isolates identified as beta-lactamase producing isolates. Conclusion: Considering the high prevalence of bacteria producing ESBL, screening for infections caused by ESBL-producing isolates may be lead to the most effective antibiotics therapies.

Background and Objectives: Urinary tract infection (UTI) is the presence of pathogens in the urinary tract. Escherichia coli and Klebsiella pneumoniae are the most common bacteria responsible for UTI. Due to the variety of antibiotic resistance mechanisms, treatment of these infections has been difficult, therefore, selection of appropriate antibiotic has an effective role in controlling and improving the infection. The present study aimed to determine the frequency and antimicrobial resistance patterns in Escherichia coli and Klebsiella pneumoniae strains isolated from outpatients with UTI referred to Amiralmomenin Ali hospital in Gerash city. Materials and Methods: This cross-sectional study was performed on urine specimens of 1300 outpatients referred to Amiralmomenin Ali hospital in Grash, during a six-month period from April to September 2017. Strains were identified using biochemical tests and differential cultivation environments. The antibiotic resistance pattern of strains was investigated by Kirby-Bauer method. Chi-square test was used for data analysis. Results: Among 1300 urine samples, 247 samples (19%) were positive for bacterial growth. 148 urine samples (11.3%) were positive for Escherichia coli and Klebsiella pneumoniae, among them 108 Escherichia coli strains (72.97%) and 40 Klebsiella pneumoniae strains (27.03%) were isolated. The most and the least antibiotic resistance in Escherichia coli was to Nalidixic Acid (59.3%) and Nitrofurantoin (22.2%), respectively. For Klebsiella pneumoniae strains, the most and the least antibiotic resistance was observed to Nitrofurantoin (67.5%) and Ciprofloxacin (25%), respectively. Conclusion: The UTI caused by Escherichia coli is more common in comparison with Klebsiella pneumoniae. For the initial treatment of urinary tract infections, the use of Nitrofurantoin, Ciprofloxacin, and Cotrimoxazole antibiotics is recommended. [ABSTRACT FROM AUTHOR]